School Nurses on the Front Lines of Healthcare: Children With Medical Devices—Shunt System Malfunctions and Infections

An important subgroup of children with special healthcare needs are those children with medical complexities who require long-term intensive healthcare interventions and treatments. As medical technology continues to advance and children with complex medical needs survive the neonatal period and progress into school-age, it is essential for school nurses to be able to recognize and acutely manage complications and malfunctions of devices in children requiring assistance from medical devices. An example of a common medical device includes shunts systems (e.g., a ventriculoperitoneal shunt) to drain excess cerebrospinal fluid. These devices put children at serious medical or surgical risk when they malfunction or become infected, so it is important for healthcare providers, especially school nurses who are the first responders in schools, to recognize malfunctions and initiate appropriate care management. This article describes the initial assessment and management of common medical emergencies in students who have those devices.